Healthcare Provider Details

I. General information

NPI: 1689007056
Provider Name (Legal Business Name): DEMETRIA ZAKIYA HOWELL M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2013
Last Update Date: 08/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1453 16TH ST
SANTA MONICA CA
90404-2715
US

IV. Provider business mailing address

1453 16TH ST
SANTA MONICA CA
90404-2715
US

V. Phone/Fax

Practice location:
  • Phone: 310-450-0650
  • Fax: 310-883-1221
Mailing address:
  • Phone: 310-450-0650
  • Fax: 310-883-1221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: